PATTERNS OF ALCOHOL USE OVER TIME AMONG OLDER COUPLES: IMPLICATIONS FOR SELF-RATED HEALTH

Abstract Alcohol use in older adults is increasing which can have implications for health outcomes. Research has examined longitudinal patterns of drinking for individuals over time, but not couples. Couples often engage in concordant drinking behaviors but it is unknown if couples become more or less concordant or discordant in their drinking over time or how increased concordance or discordance influences health. The purpose of this study was to examine patterns of alcohol use over time among older couples and their links with self-reported health. A total of 8,570 husbands and wives completed the main interview of the Health and Retirement Study (HRS) for at least three consecutive biennial waves between 1996 and 2016. Latent class growth analysis revealed five trajectories of couple drinking: 1. Concordant - husband and wife light (n = 6398, 75%); 2. Concordant - husband and wife light/moderate (n = 781, 9%); 3. Concordant - husband and wife moderate (n = 296, 3.5%); 4. Discordant - husband heavy and wife light (n = 293, 3.5%); 5. Discordant - husband moderate and wife light (n = 802, 9%). Discordant couples and concordant light couples reported worse self-rated health over time compared with concordant light/moderate and concordant moderate couples. The most common pattern of drinking was concordant drinking with husbands showing light decreasing drinking and wives showing light stable drinking over time. Findings are consistent with literature and suggest that discordant drinking couples have poorer health.


IMPROVED NALOXONE PRESCRIBING IN RURAL PRIMARY CARE FOLLOWING ACADEMIC DETAILING FOR OPIOID OVERDOSE PREVENTION Leah Tobey, Meghan Breckling, Mohab Ali, and Robin McAtee, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States
Performing opioid misuse screenings for older adults (OA) and reviewing high-risk medications are reliable screenings in preventing harm, especially accidental overdose.As one of the HRSA funded Geriatric Workforce Enhancement recipients, the AR Geriatric Education Collaborative (AGEC) worked with a rural federally qualified healthcare clinic system (ARcare) to reduce the likelihood of patient's accidental overdose by co-prescribing Naloxone, when indicated.An Academic Detailing (AD) team of a PT, PharmD and MD, led this interactive training.AD is clinician-toclinician support customized with the purpose to connect primary care providers to the best available evidence and most up-to-date clinical practice guidelines.A conversational needs assessment was stimulated where the provider shared their perspectives, knowledge deficits, and needs surrounding the AD topic of Naloxone.These AD interactions encouraged safer prescribing of high-risk medications while considering the use of hard reduction resources for patients, such as prescribing Naloxone.,066 facilities demonstrated only 24.7% of all facilities reported programming tailored for older adult care, with state-by-state analysis showing a range of 4.6% to 61.4% of treatment programs reporting older adult tailored care.The deficits of older adult programming availability are explained against the context of the 2020 Treatment Episode Dataset-Admissions (TEDS-A), administered by the CBHSQ, that examines admissions data from all 50 states, as well as the District of Columbia, U.S. territories, and Compact of Free Association (COFA) partners.The TEDS-A data consisted of 1,416,357 admissions, of which 11.8% (n=167,200) were aged 55 years-old or older.Of this older adult sample, 32.8% reported a co-occurring SUD and mental health disorder and 13.9% reported some number of days waiting to enter treatment.These (and other) client-level and facility-level factors (overall and state-by-state) will be used to emphasize specific needs for older adult SUD care.
The purpose of this study was to examine patterns of alcohol use over time among older couples and their links with self-reported health.A total of 8,570 husbands and wives completed the main interview of the Health and Retirement Study (HRS) for at least three consecutive biennial waves between 1996 and 2016.Latent class growth analysis revealed five trajectories of couple drinking: 1. Concordant -husband and wife light (n = 6398, 75%); 2. Concordant -husband and wife light/moderate (n = 781, 9%); 3. Concordant -husband and wife moderate (n = 296, 3.5%); 4. Discordanthusband heavy and wife light (n = 293, 3.5%); 5. Discordant -husband moderate and wife light (n = 802, 9%).Discordant couples and concordant light couples reported worse selfrated health over time compared with concordant light/moderate and concordant moderate couples.The most common pattern of drinking was concordant drinking with husbands showing light decreasing drinking and wives showing light stable drinking over time.Findings are consistent with literature and suggest that discordant drinking couples have poorer health.

RISKY BEHAVIORS WITH NONALCOHOLIC FATTY LIVER (NAFLD) AND NONALCOHOLIC STEATOHEPATITIS (NASH) AMONG OLDER ADULTS
Tung-Sung Tseng 1 , Wei-Ting Lin 2 , Peng-sheng Ting 3 , Chiung-Kuei Huang 3 , Po-Hung Chen 4 , and Hui-Yi Lin 1 , 1. LSUHSC, New Orleans, Louisiana, United States, 2. Tulane University, New Orleans, Louisiana, United States, 3. Tulane University School of Medicine, New Orleans, Louisiana, United States, 4. Medicine, Johns Hopkins University, Baltimore, Maryland, United States Background: Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) are emerging public health concerns among older adults, particularly those with risk behaviors.Objectives: We evaluate the association between risk behavior and the prevalence of NAFLD and NASH in older adults.Methods: A total of 1444 US individuals aged 60 years and older were included from the 2017-2020 NHANES survey.Dietary, Sugar-sweetened beverages, smoking, physical activities, stiffness, controlled attenuation parameters, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were measured.We performed multivariable logistic regression models with interaction terms and stratified analysis to assess the interplay effect between soda intake and body mass index (BMI) on liver stiffness measurements.All statistical analyses were under survey modules with an appropriate sampling weight.Results: The prevalence of NAFLD/NASH varied significantly by age, gender, race, alcohol use, BMI, total energy consumption, ALT, and (all p≤0.001).The results showed that several risk behaviors, including smoking, physical inactivity, and sweetened beverage consumption, were not significantly associated with developing and worsening NAFLD and NASH among elderly individuals.However, higher total energy consumption, obesity, and alcohol use were risk factors for NAFLD/ NASH.Conclusion: Our study findings highlight the importance of promoting some healthy lifestyle behaviors among elderly individuals to prevent the development and progression of NAFLD and NASH.Further research is needed to investigate optimal strategies for promoting healthy beh Abstract citation ID: igad104.2521

VIEWS ON HELPFUL SUBSTANCE USE RECOVERY PATHWAYS: DO OLDER AMERICANS DIFFER FROM THEIR YOUNGER COUNTERPARTS?
Naomi Meier 1 Rachita Sharma 1 , Paula Garland 1 , and Ami Moore 2 , 1. University of North Texas: Denton, Denton, Texas, United States, 2. University of North Texas, Denton, Texas, United States Recovery from substance use is generally a lifelong process with different pathways.This study used data from the Justice Community Opioid Innovation Network (JCOIN), 2021, a nationally representative survey of over 6,000 American adults, to examine factors that influence the views on most helpful pathways for recovery among older Americans (60 years and older) compared to their younger counterparts (less than 60 years old).Multiple linear regression was used to determine differences across age, political affiliation, cultural identity, and regional location.A factor analysis of 9 questions that asked respondents to rate the most helpful pathways for recovery generated three domains: 1. Medical services enabling environment (PCP, intensive inpatient program, and rehab program); 2. Direct conventional treatment (Prescription medication and therapist); and 3. Sociocultural factors/non-conventional treatment (Family/friends, spiritual/natural healer, self-help group, and faith-based organization).Older and younger Democrats, Independents, and residents of the Northeast and Midwest regions agreed that the medical services were helpful for recovery.While younger and older Democrats believed that direct conventional treatment was helpful, younger and older Republics as well as younger married people believed it to be less helpful.While older Democrats agreed that non-conventional treatments are most helpful, younger Democrats and Independents believed them to be less helpful.However, younger Republicans, Blacks and Hispanics believed that they are most helpful.Given the significant differences in the views of older and younger Americans on helpful pathways to recovery, policymakers and stakeholders are encouraged to be mindful of the several policy recommendations presented in the paper.Background and Objectives: Positive caregiving appraisal is strongly linked to health among caregivers of persons with Alzheimer's Disease and Related Dementias (ADRD).Few studies have identified predictors of positive caregiving appraisal, although research suggests that cultural factors may play a role.This study hypothesized that self-identified race and ethnicity, as well as more nuanced cultural factors such as language spoken at home,

OLDER ADULT SUBSTANCE USE DISORDER TREATMENT LANDSCAPE 2020: CLIENT-LEVEL AND FACILITY-LEVEL FACTORS
ARcare providers (n=22) attended AD on Preventing Opioid Overdose with Naloxone over 11 months.Of those, 9 had previously prescribed Naloxone 40 times pre-training then 107 times post-training; five providers had never prescribed Naloxone but prescribed it 46 times post-training.Eight providers, made no change, some of whom work in schools.Post-training data gathered from the 14 Naloxone prescribing providers showed a total of 153 Naloxone prescriptions after AD, a 283% increase.For primary care settings, age-friendly medication practices are critically important for OA safety, aging in place, and for OA and their caregivers to understand and utilize Naloxone if accidental overdose is suspected.The 2020 data from the National Survey of Substance Abuse Treatment Services (N-SSATS), administered by The Center for Behavioral Health Statistics and Quality (CBHSQ) of the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services, collects data from public/private SUD treatment facilities in the United States.Data from 16